General Question

Why isn't there some sort of nationally used pharmacy system?

I was thinking about all these ads on TV now for abuse of prescription drugs, and about all the episodes of Intervention (I’m a big fan) about people addicted to perfectly legal prescription pills, and I wondered why we can’t have some kind of system in place that is federally required for all pharmacies; a data base where you can see if that person, by SS or DOB or something, has filled a prescription anywhere in the country. That way, when people go to multiple doctors for the same prescriptions, they can’t simply go to different pharmacies to get them filled. It would almost completely eliminate the ability for people to legally obtain ridiculous amounts of medications.

9 Answers

It also could have serious repercussions for people’s privacy, poofandmook. Did you know that many people who have serious diseases such as cancer do not tell their employers for fear of losing their jobs? They get their prescriptions and pay for them without using the company health plan.

While it would be good in the sense that it might stop deaths like Heath Leger’s, the cost is too high in terms of one more loss of liberty.

@Marina: I thought about the privacy issue, but then I thought that it could be as simple as—someone goes to CVS to fill a prescription for Oxycodone. They go to the Walgreens next door and try to fill another prescription for Oxycodone. When the pharmacist at Walgreens goes to enter the information in the computer, it sees that John Doe just filled a prescription at CVS for Oxycodone on July 24th at 7:25pm. It wouldn’t have insurance information, maybe prescribing doctor information, and it would only be accessible by the pharmacy’s computer, not like information on the internet or anything, so nobody could access that information except the pharmacist. It shouldn’t have anything to do with insurance or self-pay because the idea would just be to tell the pharmacist that he can’t legally fill the script. Am I making sense? I’m sort of rambling the logistics off the top of my head.

Any company health plan that would divulge prescription information to an employer is going against HIPAA regualtions. Pharmacies do share this information amongst themselves when patient is suspected of double dipping.

We had a patient who was obviously drug seeking from more than one doctor. She has had over 40 surgeries, because she likes the attention and care afterward, and loves the drugs. We suspected munchausens syndrome. Once we discovered this trait, we turfed her over to a different surgeon.

One of our doctors called a drug store to inquire about how many prescriptions she had on file, and found out she had several narcotic scripts at several drug stores. So having a system like the one poofandmook described would be very helpful indeed.

Here in California there is legislation in the works for a database. I am firmly AGAINST it.

It is a major violation of my privacy even though I am not on any medications. Why should my personal medical information be in a database because of a slim minority of people who CHOOSE to abuse drugs? It is nobody’s business unless they are driving or harming others under the influence. While not all abusers are in pain I have known people who are in chronic- unending pain. And as a person who is NOT who am I to judge them or their survival methods?

In my mind it is the same as having a database of those who drink.

I for one am really tired of so many LAWS that eat away at our PRIVACY.

Yeah- they might also ensure that the database is private- only for medical personnel- but these sites are hacked DAILY.

the other reason for it would be so doctors have access to complete records when patients are seen. I’m an ER doctor, and a fair number of patietns do not know what medications they are on, especially if they are on more than five. those are the patients i really need to know what they are taking. A lot of times they get their medications at a national chain pharmacy, but if they get it at the VA fugetaboutit – i’ll never know what they’re on.

@Dog – equally concerning for privacy advocates are moves to a national standard for electronic medical records. I know as a doctor its very important for me to know what happened to the patients i’m seeing, but probalby security concerns are not being adequately addressed.

@drhat77 I would want absolutely want an emergency physician to have such access. It is the motivation behind the database system that I am against- big brother- seeking those who are breaking the law. You are right that there are no easy answers.

@Dog I agree that we already have very little privacy. If you have insurance, your medications are already in someone’s database. The insurance company’s. I got a letter from my insurance company 6 months ago saying that an employee’s laptop was stolen, and it contained all my information. Needless to say, I was furious about it. They gave me a free identity theft protection program for 1 year, but that doesn’t make me feel any more secure.

So saying there is no easy answer is an understatement. There are several very good reasons both for and against this type of program. I would have to say that because medical information is already on a databse, and at risk anyway I’d lean towards wanting the system. If I was taking a medicine that didn’t mix well with another and got it from a pharmacy I didn’t normally use, I’d like them to be able to see that and advise me.

There is a national system that will let a pharmacy see if the SAME script has already been filled but not if multiple scripts for the same drug have been filled. I will have to check with my pharmacy contact to get the name of the software. I think there are actually a few companies that offer this service to pharmacies. They ping your script to see if you have insurance, Medicaid, etc and if the script has already been filled. This is important if a doctor writes a paper script and calls in the same script—designed to help ensure the pharmacy gets paid for filling (many insurers put limits on how frequently your script can be refilled, some of the most common are “no refills before 25 days have elapsed” and others are 28 days).